Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.
This essay is in response to: What are the health hazards of exposure to fragrances in consumer products and cosmetics? How can our regulatory system effectively address such hazards?
Society is steeped in fragranced consumer products: air fresheners, soaps, hand sanitizers, lotions, shampoos, laundry supplies, candles, and cleaners. These products emit numerous chemicals, including some classified as toxic or hazardous, and even some with no exposure level considered safe. But society may not know about potential hazards.
Fragranced products are associated with a range of adverse health effects, such as migraine headaches, asthma attacks, mucosal symptoms, respiratory irritation, and contact dermatitis.[i] And fragrance sensitivity is widespread. In surveys, more than 30% of Americans report adverse effects when exposed to fragranced products, and 19% report breathing difficulties, headaches, or other health problems when exposed to air fresheners and deodorizers; percentages are nearly twice as high for asthmatics.[ii]
No law requires the disclosure of all ingredients in consumer products, or of any ingredients in a product's "fragrance," which is typically a mixture of several dozen to several hundred chemicals, most synthetic.[iii] Ingredient disclosure requirements depend on the product. For air fresheners, laundry supplies, cleaners, and other products regulated by the Consumer Product Safety Commission, ingredients do not need to be fully listed on either the label or the material safety data sheet (MSDS), not even the presence of a "fragrance." For personal care products, cosmetics, and other products regulated by the Food and Drug Administration, ingredients need to be listed on the label, but not the MSDS. For all products, the general term "fragrance" can be listed on the label, or a related term (such as "perfume"), rather than any of the specific ingredients in a fragrance.[iv]
So, it's the perfect storm: Products are pervasive. Exposure to products can cause adverse health effects. Ingredients in products are not fully disclosed.
Product formulations are not only confidential; they're also complex. For instance, analyses of 25 best-selling fragranced products found more than 133 different volatile organic compounds (VOCs), with 24 classified as toxic or hazardous under federal laws, including 4 probable carcinogens. "Green," "natural," and "organic" fragranced products emitted just as many hazardous chemicals as regular fragranced products. Of more than 420 chemicals emitted collectively, only 2 were listed on any product label.[v]
Even if a product doesn't contain hazardous pollutants, it can nonetheless generate them. For instance, limonene and other terpenes, common fragrance chemicals, react readily with ozone in surrounding air to create secondary pollutants, such as formaldehyde, acetaldehyde, acetone, and ultrafine particles.[vi]
Moreover, products can affect both personal health and public health. For instance, emissions from dryer vents, during the use of fragranced laundry products, include numerous VOCs that affect outdoor air quality, such as acetaldehyde, a probable carcinogen and Hazardous Air Pollutant.[vii] Like secondhand smoke, "secondhand scents" can cause health problems for many people when others use fragranced products.
What can we do to reduce hazards? We can choose products without any fragrance, perfume, or scent, even those called "organic" or "natural." While "fragrance-free" does not necessarily mean non-toxic (because a product base can contain other potentially toxic ingredients), the risks associated with exposure to fragrances can nonetheless be reduced. (Note that an "unscented" or "neutralizer" product can actually be a fragranced product with a masking fragrance used to cover the scent.)
We can implement fragrance-free policies, as many workplaces, schools, and organizations have done.[viii] Public restrooms should be free of air fresheners and deodorizers, which mask a problem and pose risks, especially for individuals with serious reactions to them. Soaps in restrooms should also be fragrance-free, as many cannot use fragranced soap.
We can support the disclosure of all ingredients in products, and in the chemical mixture called "fragrance" in those products. But we also need to support research on how and why these products can cause health problems. Do problems result from specific ingredients, mixtures, or both? Do problems occur because an ingredient is synthetic rather than truly natural? And what are the biomarkers of exposure and effect?
Thus, the perfect storm creates the perfect opportunity: We can use the case of fragranced consumer products to improve our understanding of toxicity, the links between ingredients and health effects, and the regulations and product testing criteria that can more effectively safeguard public health.
Endnotes
[i] Elberling J, Linneberg A, Dirksen A, Johansen JD, Frølund L, Madsen F, et al. Mucosal symptoms elicited by fragrance products in a population-based sample in relation to atopy and bronchial hyper-reactivity. Clin Exp Allergy 2005;35(1):75-81. Johansen JD. Fragrance contact allergy: a clinical review. Am J Clin Dermatol 2003;4 (11):789-98. Kelman L. Osmophobia and taste abnormality in migraineurs: a tertiary care study. Headache 2004;44(10):1019-23. Kumar P, Caradonna-Graham VM, Gupta S, Cai X, Rao PN, Thompson J. Inhalation challenge effects of perfume scent strips in patients with asthma. Ann Allergy Asthma Immunol 1995;75(5):429-33. Millqvist E, Löwhagen O. Placebo-controlled challenges with perfume in patients with asthma-like symptoms. Allergy 1996;51(6):434-39.
[ii] Caress SM, Steinemann, AC. Prevalence of fragrance sensitivity in the American population. J Environ Health 2009;71(7):46-50.
[iii] Somogyi L, Janshekar H, Takei N. Aroma chemicals and the fragrance and flavor industry. Stanford Research Institute International, CEH Review, 1998, p. 503.5000F.
[iv] Steinemann AC. Fragranced consumer products and undisclosed ingredients. Environ Impact Assess Rev 2009; 29(1):32-38
[v] Steinemann AC, MacGregor IC, Gordon SM, Gallagher LG, Davis AL, Ribeiro DS, Wallace LA. Fragranced consumer products: chemicals emitted, ingredients unlisted. Environ Impact Assess Rev 2011; 31(3):328–333
[vi] Nazaroff WW, Weschler CJ. Cleaning products and air fresheners: exposure to primary and secondary air pollutants. Atmos Environ 2004;38(18):2841-65. Destaillats H, Lunden MM, Singer BC, Coleman BK, Hodgson AT, Weschler CJ, Nazaroff WW. Indoor secondary pollutants from household product emissions in the presence of ozone: A bench-scale chamber study. Environ Sci Technol 2006;40(14):4421-28.
[vii] Steinemann, AC, Gallagher, LG, Davis, AL, MacGregor, IC. Chemical emissions from residential dryer vents during use of fragranced laundry products. Air Quality, Atmosphere and Health. 2011.
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i agree with judy stephenson,
December 25, 2012Because chemical fragrances are so toxic, I believe all TV and radio or web or print ads for products containing fragrance should be required by law to contain the same type of warnings that ads for prescription drugs must have.
January 5, 2012I'm sending this to WholeFoods. So sick of getting sick there.
December 30, 2011Thank you for asking that the questions be asked.
November 15, 2011Excellent analysis and references.
November 6, 2011The most insidious additives are the odor eliminators which work by killing the sense of smell. I value my senses and would vote to ban these substances if I had a chance. Is there a URL for a list of products which work by killing the sense of smell?
November 5, 2011